INTRODUCTION

Menstruation, or period, is normal vaginal bleeding that occurs as part of a woman's

monthly cycle. Every month, your body prepares for pregnancy. If no pregnancy occurs, the
uterus, or womb, sheds its lining. The menstrual blood is partly blood and partly tissue from
inside the uterus. It passes out of the body through the vagina.
Periods usually start between age 11 and 14 and continue until menopause at about age
51. They usually last from three to five days. Besides bleeding from the vagina, you may
cravings, Mood swings and irritability, Headache and fatigue.
Premenstrual syndrome, or PMS, is a group of symptoms that start before the period. It can
include emotional and physical symptoms.
MEDLINE PLUS,22 May 2017, Menstruation, [ available at] https://medlineplus.gov/menstruation.html#cat_51

Menstruation has may effects on girls and women, including emotional and self-image
issues. In the united states, the average age at menarche ( the start of menstruation in females) is
12.8 years, with a range between 8 and 18. Genetics is the most important factor in determining
the age at which menarche starts, but geographic location, nutrition, weight, general health,
nutrition, and psychological factors are also important (Shelby & Ruocco , 2007).
Susan Scott Ricci “Essentials Of Maternity ,Newborn &Women, ‘S Health Nursing( Second Edition),
Publication By Lippincott Williams&Wikkins,Page No 52,-

According to WHO (World Health Organization ) the age defines 10-19 years as
‘adolescents’. The word adolescent is derived from the latin word “adolescere” , which means to
grow into maturity. In many societies, however, adolescence is narrowly equated
with puberty and the cycle of physical changes culminating in reproductive maturity.

World health organization. Factsheet on adolescent health. Geneva: WHO. 3Apr2020.[ Available at:]
https://www.britannica.com/science/adolescence

According to India’s population data in march 2020 the current population of India is
1.35 billion and among those people 46% of population lies between 10-19 years. India has
around 355 million menstruating women and girls who face multilayered barriers to effective
Menstrual Hygiene Management (MHM) due to various social and economic factors. According
to the latest data collated by the ministry of health, only 12% of women and girls have access to
sanitary napkins in India while a majority of them relies on outdated, unhygienic methods during
menstruation. 
News & event, Only 48% of the adolescent girls population in India are aware about menstruation
prior to the first period, 28 May 2019, [ Available at:]
https://www.dasra.org/news-and-events/only-48-of-the-adolescent-girls-population-in-india-are-aware-about-menstruation-prior-
to-the-first-period
According to the National Family Health Survey of 2015-16, it estimated that out of 336
million menstruating women in India only 121 million use sanitary pads locally or commercially
produced which is roughly about only 36 per cent. And about 57.6 percent of the Indian women
use sanitary napkins and 62 percent women in the age group 15-24 years still rely on a cloth
during periods.

Surajbhan SN, Menstrual Hygiene: The untalked taboo of India, 23 Apr 2020, [ Available at:]
https://countercurrents.org/2020/04/menstrual-hygiene-the-untalked-taboo-of-india
According to a National Family Health Survey (NFHS) report published in 2017, only 58
percent of women in India aged 15 to 24 uses a hygienic method of menstrual protection, the
Hindu daily reported.
APA citation: Sanitary pad record in India to promote menstrual hygiene (2019, January 11) retrieved,
14 May 2020 [ Available at:] https://medicalxpress.com/news/2019-01-sanitary-pad-india-menstrual-
hygiene.html

National Family Health Survey 2018 estimates that of the 336 million menstruating women in
India about 121 million (roughly 42 percent) women are using sanitary napkins, locally or
commercially produced. Nationwide stunting of the production of sanitary napkins will affect
the hygienic conditions of these women, making them vulnerable to various diseases and
menstrual infections.
Das Abira, inaccessibility to menstrual hygiene in times of COVID-19, 14May2020, [ Available at:]

https://feminisminindia.com/2020/03/31/inaccessibility-menstrual-hygiene-times-covid-19/

According to census 2020 the current population of uttarakhand is 1.01 crore

uttarakhand. National Family Health Survey 4 stating that 55 percent of women between the age
of 15 -24 in Uttarakhand.
Population in India.
Family health survery 4 Census 2020 population of women in uttarakhand, [ Available at:]
http://www.indiaonlinepages.com/population/india-current-population.html
Girls and women have very less or no knowledge about reproductive tract infections caused due
to ignorance of personal hygiene during menstruation time. Even many studies have shown that
the girls lack knowledge about menstruation and due to lack of hygiene, they are likely to suffer
from RTI’s. Studies have shown that the girls lack knowledge about menstruation and due to
lack of hygiene, they are likely to suffer from RTI’s.

Kaur Rajanbir, Kaur Kanwaljit, and Kaur Rajinder, Journal of Environmental and Public Health , Menstrual
Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries
20Feb2018 . [ Available at:] https://www.hindawi.com/journals/jeph/2018/1730964/

Menstruation and menstrual practices still face many social, cultural, and religious
restrictions which are a big barrier in the path of menstrual hygiene management. In many parts
of the country especially in rural areas girls are not prepared and aware about menstruation so
they face many difficulties and challenges at home, schools, and work places. Girls and women
have very less or no knowledge about reproductive tract infections caused due to ignorance of
personal hygiene during menstruation time. In rural areas, women do not have access to sanitary
products or they know very little about the types and method of using them or are unable to
afford such products due to high cost. So, they mostly rely on reusable cloth pads which they
wash and use again.

UNICEF JOURNAL, Guidance Of Menstrual Hygiene. March 2019, [ Available at:]

https://www.unicef.org/wash/files/UNICEF-Guidance-menstrual-health-hygiene-2019.pdf
Menstruation is a normal physiological phenomenon that women and adolescent girls
experience every month. Ability to manage menstruation hygienically is fundamental to the
dignity and well-being of women and constitutes an integral component of basic hygiene,
sanitation, and reproductive health services. Poor awareness of the physiology, unscientific
attitude, myths, and misconceptions including the notion that menstruating women are
“contaminated,” “dirty,” and “impure” adversely affect their health and social lives.
Issues and challenges related to menstrual hygiene management (MHM) in low and
middle-income countries are gaining increased recognition in the water, sanitation, and hygiene
(WASH) sector globally. WHO and UNICEF (2014) have defined MHM as “Women and girls
are using clean menstrual hygiene management material to absorb or collect blood, that can be
changed in privacy, using soap and water for washing the body as required and having access to
facilities to dispose of used menstrual management materials.” Since 2014, May 28 is observed
as the Menstrual Hygiene Day worldwide to raise awareness regarding the challenges women
and girls face to deal with menstrual cycles and highlight solutions implementable at global,
national, and local levels to address these issues.
Resources on MHM; About Menstrual Hygiene Day.2020 [Available at]
http://www.menstrualhygieneday.org/about/about-mhday/.
An article on “Uttarakhand: Due To Temples On The Way, Menstruating Girls Stopped
From Going To School”. Menstruation is a taboo in our country to such an extent that parents in
Rautgara village in Pithoragarh. The young girls of the village are stopped from going to school
during the 5 days of their period. Every month, the girls are not allowed to go as the road they
pass by has temples and deities. Locals believe that if the girls pass through, the holy temples
will get desecrated. Whereas, some girls who are determined to complete their education, have
shifted to nearby villages or towns with their relatives to attend school. Advertisement This issue
was first spotted by an NGO called Uttarakhand Mahila Manch. Talking to The Times of India,
Uma Bhatt, who led the team, said that the girls go to Sail Government Intercollege and have
been skipping school every month for 5 days. A team of the local administration is supposed to
visit the village to spread awareness about menstruation. Teachers have been trying to
encourage girls to attend classes but parents fear backlash from the community and thus don’t
allow the girls to go to school.
Bagchi Poorbita Bagchi, Uttarakhand: Due To Temples On The Way, Menstruating Girls Stopped From
Going To School 28 Nov 2018 [Available at] https://thelogicalindian.com/news/menstruation-school-stop/?
infinitescroll=1

The study is show regarding menstrual hygiene related knowledge and practice among
adolescent girls in selected urban and rural community area almora (uk). In this  study the
researcher wants to find out the knowledge and practice of the girls and their problems during
menstruation. According to Menstrual Health in India / Landscape Analysis (2016) There are
over 355 million menstruating women and girls in India, but millions of women across the
country still face significant barriers to a comfortable and dignified experience with menstrual
hygiene management (MHM). A study found that 71% of girls in India report having no
knowledge of menstruation before their first period. At menarche, schoolgirls in Jaipur,
Rajasthan report their dominant feelings to be shock (25%), fear (30%), anxiety (69%), guilt
(22%), and frustration (22%). Further, 70% of women in India say their family cannot afford to
buy sanitary pads. Although there is evidence in India illustrating the problem, the
evidence linking the impact of poor menstrual health, an encompassing term for menarche
and MHM, on critical outcomes is limited.
So, that is the reason, why researcher is interested to work on this topic with the girls of
rural and urban areas, because the adolescent’s age is the initial stage of menstruation. The
adolescent girls facing so many problems during this period for example cramps during
menstruation, fear related pre menstrual syndrome, stigma related to menstruation, especially in
rural areas they following some rituals and irregular menstrual cycle, social taboo etc. because
of lack of knowledge and practices they facing so many problems for example UTI, fungal
infection, poor hygiene, due to lack of diet they suffer from anemia etc.
Even they don’t know about the government facilities. So researcher want to provide
information about government schemes like On the occasion of Menstrual Hygiene Day on May
28, the state government of Uttarakhand announced that to promote menstrual hygiene among
young girls and women, especially in rural areas, Anganwadi centres in the districts of
Dehradun, Pauri, Pithoragarh and Almora will sell low-cost sanitary napkins on the fifth of
every month. And after using sanitary napkins to ensure safe disposal, to increase access to and
used of good quality sanitary napkins. And also want to give information regarding hygiene, diet
etc. and want to know that what they feel, what they think, what and why they follow some
unnecessary rituals. The little contribution from our side to give the knowledge and the correct
practice during menstruation period will be helpful for our community